Men’s testosterone levels remain pretty steady until age 70. After that, production of the male sex hormone starts to decline, new research indicates. This begs the question: Is testosterone loss among seniors really a function of the normal aging process? Or might it reflect other health issues that often confront men as they get older? Both may be true, say investigators, with obesity, high blood pressure, diabetes and even marital status among the factors that appear to drive testosterone levels down, in conjunction with age. When testosterone does fall, the result may be increased weakness and fatigue, diminished sexual performance, loss of muscle mass, and a higher risk for diabetes and dementia. While you can’t do anything about your age, the findings suggest some positive lifestyle changes might help preserve your masculinity. Study author Bu Yeap said that after 70 the pituitary gland at the base of the brain actually sends out signals to increase, not decrease, testosterone production. To find out what might be short-circuiting that signal, the study team analyzed 11 studies from Australia, Europe and North America, involving some 25,000 men in total, said Yeap, an endocrinologist and medical school professor at the University of Western Australia. All the studies were conducted prior to 2020. In each, men’s testosterone levels were repeatedly measured over time using a technique called mass spectrometry. Collectively,…  read on >  read on >

It’s known that older men with type 2 diabetes have higher odds for erectile dysfunction, or ED. Now, new research suggests problems in the bedroom for younger men may signal undiagnosed prediabetes or diabetes. Researchers found that men 40 and younger with ED have about a one-third increased risk for prediabetes or full-blown type 2 diabetes compared to men without impotence. The results indicate younger patients with ED should be screened for diabetes, they say. “This indicates a remarkable ability to predict the potential onset of illness and treat it early with lifestyle or medication,” study co-author Dr. Jane Tucker said in a school news release. She’s an associate professor of family and community medicine at Saint Louis University. For the study, Tucker and her colleagues looked at the electronic health data of more than 1.9 million male patients from 2008 to 2022 and examined the links between these two conditions, at a time when 2.5% of the U.S. population has persistent, undiagnosed diabetes. Narrowing it down to men aged 18 to 40, the researchers found that ED patients had a 34% increased risk for prediabetes or type 2 diabetes. Additionally, 75% of patients developed prediabetes or type 2 diabetes within a year of ED diagnosis. The prevalence of undiagnosed diabetes declined from 1988 to 2020 in the United States. Yet about 8.5 million adults…  read on >  read on >

Using ECMO, a highly advanced form of breathing support, does not appear to complicate treatment for obese adults in intensive care. ECMO, which is short for extracorporeal membrane oxygenation, may even help these patients when they experience respiratory failure, despite the fact that its use has been questioned for those with obesity. Obese patients who received ECMO for acute respiratory distress syndrome (ARDS) had lower death rates compared to patients with ARDS who received ECMO and were not obese, according to the study funded by the U.S. National Institutes of Health (NIH). To come to that conclusion, the researchers reviewed data from 790 patients from more than 20 medical centers across 10 countries who received ECMO for ARDS. In all, 320 of these patients were obese. The study found 24% of patients with obesity died in the intensive care unit, compared to 35% of patients who weren’t obese. Although the authors couldn’t control for all variables, including disease severity, they concluded the findings support the concept that obesity shouldn’t factor into treatment decisions for ECMO. “We hope that clinicians will consider the data from this study when making bedside decisions for ARDS patients with obesity, instead of preemptively withholding this lifesaving therapy,” study author Dr. Darya Rudym, a pulmonologist and assistant professor of medicine at NYU Langone Health in New York City, said in an…  read on >  read on >

When the pandemic began, spending on mental health services skyrocketed and it continues to rise even as use of telehealth services leveled off. That’s the key takeaway from a new study published Aug. 25 in JAMA Health Forum. Some rules for expanded payment for telehealth services have now expired, so it’s not known whether this level of spending will continue, according to researchers at the RAND Corporation and Castlight Health. “If greater utilization of health services drives higher health care spending, insurers may begin pushing back on the new status quo,” said lead author Jonathan Cantor, a policy researcher at RAND, a nonprofit research organization. “Insurers may look for ways to curb costs and that could mean less flexibility about using telehealth for mental health services,” he said in a RAND news release. Cantor and his colleagues found that spending on mental health services rose 53.7% between March 2020 and August 2022 in a large group of people with employer-provided insurance. Use of mental health services increased by nearly 39%, according to the research, which used claims data from about 7 million commercially insured adults. The analysis included anxiety disorders, major depressive disorder, bipolar disorder, schizophrenia and PTSD. The claims information was from Castlight Health, a health benefit manager for employer-sponsored health insurance plans for about 200 employers nationwide. From March 2020 to December 2020,…  read on >  read on >